Recurrent Miscarriage Recomended Tests

[JaneSmith8]

Hi,
I just had my 3rd miscarriage in the last 18months and I've been referred to the NHS RMC but the waiting list is 6months (!) and I can't wait that long (I'm 38).

I'm going to go private; however I'm a bit lost on where to start, all I can see is either a) usual blood tests+utrasound or b) inmune testing.

I've never had any test done (only the usual blood tests from time to time that never shown anything odd) and I'm still waiting the results on the 3rd MC.

Any help is welcome :)

Hi, I’m in a similar situation - still doing research but a few things I’ve found so far.

The miscarriage association has a leaflet on tests that can be done for recurrent miscarriage

I was planning to phone Tommys for advice on where I could get them done privately

so far I’ve found the following places doing packages - Bourne hall near Cambridge has a recurrent miscarriage clinic/ the recurrent miscarriage clinic London/ aurora healthcare in Manchester - probably lots more but those are the packages that I’ve found so far. Lots of people on here also recommend dr Shehata in London.

Im hoping to get mine booked this week so will post again if I find out any more places - hopefully there will be some
other recommendations on here too from people who know a bit more :)

Usually you just book an initial appointment with the clinician and then they decide on what tests to do. You don't just decide yourself.

Did you get the testing on your last miscarriage? We did this after the 3rd miscarriage (went for surgical management). Came back as a chromosome abnormalities. Went on to have chromosome testing but we were fine for that. I had a an issue with blood clotting (they tested) so was recommended aspirin and blood thinners as soon as I found out I was pregnant. Husband had normal test diagnosis - well better than normal which annoyed me irrationally!!

Thanks Prettyflowersallyear, yes found similar places. But I guess that's the question, all those places offer blood tests and ultrasounds mostly while I've read a bunch of names in forums (Prof. S etc) that specialise in immune testing so not sure where to go 1st.

Hi Wictc, we are still waiting the results of the surgical management. How long did you have to wait for yours?

Hi, I am now also thinking about this as just got out another scan where there is no heartbeat

I had to wait quite a while. We were told not to try until the results were back in case of a chromosomal issue.

Some of the bupa hospitals have blood test labs attached where you can pay to have blood tests. They are not too badly priced either, depending on you idea of expensive I guess. Recommend
Blood coagulation test
Vitamin d level test
Folate level
Vitamin b12
Immune profile which will tell you if you have positive antinuclear antibodies for example.
Always worth checking for celiac disease as a possibility. Not everyone has symptoms.

Good luck, whatever you decide

Hi OP and may I say I am so, so sorry for your losses.

I suffered 3x miscarriages within a year and now have a healthy 2yo boy, so please don't lose hope.

I went private after the third miscarriage and without the incredible Dr I was fortunate enough to have, I know in my bones the DS wouldn't be here today.

Dr Rami Atalla is an incredible Dr and if anyone reading this is in a similar situation and able to travel to see him, I cannot recommend him enough.

He tested me for more than double what the NHS would have, and EVERYTHING came back negative and no clear reason for the losses.

He set me up with a clear path and plan to try again (happy to share details if anyone interested) and it was his care and dedication the helped me to carry my boy to full term.

Going private is the answer, if you can, and Dr Atalla if you're in this part of the UK!

All the best x

Sorry you’re in this shitty boat. I had 3 in 10 months and all the testing.

TSH, clotting, karotyping were the big ones they checked me for. All normal.

Push strongly for a semen analysis as in the end that’s what ours was but my doctor kept putting me through the wringer before even looking at DH as a cause.

Thank you all for your messages and I'm so sorry for your losses, it s*

Agree, @Rtmhwales I think they should also be tested, not just us.
@3mm4, I think Dr Atalla is my NHS referral, but have seen he's also in a few private hospitals in the area; will check -thanks!

Hi @JaneSmith8 sorry you're going through this. It might be worth speaking to your GP and ask if they'll do any blood tests, I was able to get a lot of the standard tests done after 2 miscarriages which saved time and money (the main tests would be thyroid, clotting & vitamin D).

I echo what @Rtmhwales says about pushing for semen analysis & sperm DNA fragmentation, especially if your tests don't show anything.

One other private test you might want to consider is for the MTHFR mutations which are very common but can raise the risk of miscarriage.

3MM4 I would be really interested to hear about your path to success if you wouldn't mind sharing as you mention. Thank you

After 3 miscarriages in a year, we requested (as is your right) to see prof Quenby at Coventry/University of Warwick. She was conducting a trial with Tommys. She was excellent. Keep the faith-we have a gorgeous 4 year old now.

We had tests at our local hospital after the first three but can’t honestly remember what they were. I know we both had genetic testing and it was found one of my husbands chromosomes was upside down in one pair and the other was the right way round and they told us 50/50 odds.

However we had a further three so six in a row and got referred to St Mary’s in London. They did something called a thromboelastogram test on me six weeks apart and it was slightly raised once, the upshot was I had to take aspirin as soon as I found out I was pregnant. The result of the aspirin turns 12 soon.

In case anyone is interested...
I went private and I had tests done for aenamia, lupus, Thombophilias, Tyroids, TEG which all came back fine (I have one mutation that could develop blood clots later in life and for that one they gave me high dose folic acid) and internal scan which showed some potential scarring and I need to have a hysteroscopy (I don't think this caused my MCs rather is a result of the latest surgery I had).

After all the waiting for the tests I feel that I know as much as when I started - nothing; and my age is starting to weight on me 😭

I’m sorry, it’s so frustrating. How were your partner’s test results if they’ve come back yet?

Hi - you have ruled out a few things out though, which is helpful.

I ended up going with Bourn hall and got my results back this week. Also largely fine but I now know my last pregnancy has trisomy 21 (through tests that the hospital did). Am looking into ivf/ pgta options to see if they could help.

I guess so. We started with tests on me, then we may move to husband.

@Prettyflowersallyear did they suggested you to check ivf options or is it your idea as they didn't really find anything?

Hi - they suggested it but just as one option. Trying again naturally is also an option of course and they recommended progesterone following a positive pregnancy test. I think I will try naturally one more time, but also use that time to research IVF clinics as a backup option so at least I have a bit of a plan in place.

What are your thoughts on what you will do next? 💐

I also recommend Dr Atalla. I saw him privately (and his initial consultation and blood tests were paid via Bupa so if you have private medical insurance through work I'd recommend checking this out to save you lots of money). I also then saw him during my last pregnancy and he was brilliant - unfortunately that also ended in miscarriage because of a chromosome abnormality but he picked up the phone to my local NHS EPU and advocated on my behalf that I needed a scan tomorrow and told them what testing etc was needed on the pregnancy tissue - I would have not got that nhs support without him. I will be going back to see him privately shortly on next steps. He's also been the most balanced person I've spoken to comparing him to all the fertility clinics I've dealt with.

We'll try again naturally at least once more, hard to tell if that one doesn't stick if we'll keep on trying.
I've never considered IVF as there is also a risk to MC and I usually have no issues to get pregnant, but 40s are getting closer each day so is hard to tell.

@twoforwardandtwoback I think Dr. Atalla is my NHS referral in a few months.

Is great that you could get help from your work medical insurance; mine doesn't cover MC investigations - they don't consider them relevant enough.

@3mm4 I would be very interested in the path Dr Atala recommended for trying again please? I have just had bad news about my third pregnancy in a year, with no clear reasons.

I am so, so sorry to hear. Take the time you need to grieve and feel the feels. Be kind to yourself.

Mr Atalla tested me for everything and found no rhyme or reason for the miscarriages. Nothing at all was abnormal.

He had me collect medication and have at home ready to go, then start doing pregnancy tests every day first thing from a week before my period was due. I had a faint positive after 3 days. He sent me for an HCG blood test that very day and every 48h thereafter to track the increase to keep a close eye on the baby. I was using hormonal pessaries 3x daily, injecting blood thinners and taking a steroid tablet also. Plus seeing him weekly for the first 3 months.

Miraculously, after the 3 months, he was able to ‘discharge’ me to continue a perfectly normal and healthy pregnancy and baby.

I know in my bones it wouldn’t have been this way without him and the treatment, and never would be again.

George was delivered via (a beautifully calm and wonderful) caesarean as he was breach. The surgeon noted that I had a heart shaped uterus, which would go some way to explain a failed ECV (ouch!!) and could possibly be a reason for the losses. I guess I’ll never really know, and I won’t be trying to find out any time soon. Counting my blessings daily for one healthy baby boy.

Sending love and my very, very best wishes to you. I was in the exact same situation as you and this weekend have celebrated my little boys 3rd birthday. Never give up hope xoxo